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ȣ - 510625 190 |
Impact of Chronic Renal Insufficiency on Clinical and Angiographic Outcomes in Patients Undergoing Percutaneous Coronary Intervention |
고려대학교 구로병원 순환기내과 |
Kang-yin Chen, 나승운, Zhe Jin, Yoshiyasu Minami,김지훈, 나진오,서순용, 최철웅, 김진원,김응주,박창규,서홍석,오동주 |
Background: Chronic renal insufficiency (CRI) has known to be related to higher rates of repeat pecutaneous coronary intervention (PCI) and mortality. We investigated whether CRI has adverse impact on clinical and angiographic outcomes in a series of Asian population in the drug eluting stent (DES) era.
Method: A total 71 CRI patients (pts) whose creatinine level on admission was higher than 2mg/dL and underwent PCI with DES were classified as CRI group. A total 782 pts with normal renal function were classified as Non-CRI group. Angiographic and clinical outcomes at 6 months were evaluated.
Result: Baseline characteristics were similar except CRI group had higher mean BUN levels (21.66±10.66 vs. 16.36±15.48, p=0.001) and creatinine levels (1.85±1.60 vs.1.03±1.02 mg/dL, p=0.001) than those of Non-CRI group. At 6 months, the CRI group had significantly higher incidence of binary restenosis, higher restenosis percent and late loss (Table). Although the incidence of Q-wave MI, repeat PCI, MACE and stent thrombosis were not different between the two groups, mortality was higher in the CRI group.
Conclusion: Even in the era of DES, chronic renal insufficiency had an adverse impact on the clinical and CAG outcomes of PCI with higher rates of intrastent restenosis and cardiac death.
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Table:
Angiographic and clinical outcomes at 6 months
Variable,
n (%) |
CRI group
(n=71 pts, 117
Lesions) |
Non-CRI group
(n=782 pts, 1223
Lesions) |
P value |
Binary
restenosis |
13 (11.1) |
70 (5.7) |
0.001 |
%
Restenosis |
34.95±26.19 |
25.50±22.23 |
0.004 |
Late lose, mm |
0.86±0.73 |
0.64±0.67 |
0.049 |
Cardiac
death |
5 (7.0) |
14 (1.8) |
0.004 |
Total
death |
6 (8.5) |
22 (2.8) |
0.025 |
Q-wave
MI |
0 (0) |
2 (0.3) |
1.000 |
TLR |
0 (0) |
8 (1.0) |
1.000 |
TVR |
0 (0) |
9 (1.2) |
1.000 |
TVR-MACE |
6 (8.5) |
31 (4.0) |
0.116 |
Stent
thrombosis |
1 (1.4) |
4 (0.5) |
0.353 |
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